Practice Management News and Views from around the World – October 2012

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What’s happening in small animal practice in the UK

Selected data from the MAI consolidated report to July 2012

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The Measure of Success

From an article in the Hill’s Veterinary Matters newsletter

Irrespective of all the emotion, care and worry that goes into their patients, any practice partner knows that the bottom line is just as important for a veterinary business as it is for any other. Aspirational partners sometimes find it hard to assess beyond the basics whether their practice is really performing financially. Benchmarking could be the answer.

The process of benchmarking allows the assessment of performance of an employee/group/company/corporation to be compared to relevant peers, using a pre-defined set of metrics. The results can then be used to identify problem areas that can be improved to increase profitability.

It may sound daunting to some, but a common alternative name for the process, ‘best practice benchmarking’, is something that vets can probably relate to more. Best Practice Benchmarking is a technique that allows comparison to the best in the industry and can even show previously unidentified factors that are affecting revenue. For this reason, the benefits can be extraordinary and some surprising realisations can be made.

The process of benchmarking need not be arduous or time-consuming. There is no single method that has been universally adopted, but Robert Camp, author of one of the earliest books on the subject in 1989, proposed a 12-step approach, which is worth looking at in more detail for a more in depth understanding of methodology.

Identify how to successfully measure metrics

It is relatively straightforward to calculate simple metrics from the annual accounts. Outgoings such as salaries, consumables and drug costs, business rental and bills etc. are standard markers of where money is going. Equally, income can be tracked by measuring overall takings. Things can perhaps be taken to the next level by calculating the average transaction value, but what about more complicated effects on profitability? An individual’s ability to generate repeat business, for example, is something that you certainly want to identify and encourage.

You’ve already paid for it

Luckily, today’s modern veterinary management software programmes have included the measurement of performance metrics at their core. When set up correctly, these programmes can be used to glean all sorts of statistical data from clinical notes, requiring no extra input from staff. Most programmes allow specific clinical areas to be focused on, allowing specific areas of high income to be nurtured and areas that are not achieving good margins to be re-assessed. Many conclusions and measurements can be made using data that initially seems unrelated to what is being measured. It is certainly a shrewd move to talk to your software support staff and ask for explanations and demonstrations of the programme’s capabilities in this field. To not use the full applications of an expensive computer programme is surely a massive waste of resources?

Networking

Organisations such as the Veterinary Practice Management Association (VPMA) have been established to create a community of practice partners and managers that can communicate about all aspects of practice management. With online forums, business CPD events, educational resources and a lively membership, these organisations are a brilliant way to improve, learn and share.

Get in the big boys.

The most hands-off way to implement benchmarking is to employ a specialist company. The main benefit of this is, as experienced professionals, it can be assured that they do things properly. Obviously this will be at a cost though. There are many companies specialising in these services and they can often focus on specific areas, such as customer service or straightforward finance.

Analysing results

Whether against other practices, between branches, individuals or time periods, analysis of benchmarking results is inevitably about comparison. In-house comparisons are relatively easy to implement, with single benchmarking events for all those to be compared providing data. Individual employee benchmarking needs to be approached sensitively, but handled correctly, can
be a fabulous motivational tool.

Time period comparison requires repeated benchmarking events and over time can provide clear information about trends. Being aware of chronological and seasonal data can make the hard times easier to weather (“it was quiet this time last year too”) and allow the development of strategic, time-sensitive promotions to increase profits in traditionally lean months. It also allows disturbing negative trends to be quickly identified and turned around before they cause too much damage.

For external comparison, Veterinary Business Briefing has created a free online tool that allows practice managers to perform a simple comparison to other practices similar to theirs in size and structure. All information is confidential and it can provide an insight to how a practice is performing at a national level.

Implementing change

Once the key areas for improvement have been identified, changes need to be made to tackle them. Communication is key, be it on an individual review basis, or to the whole team. Being open with colleagues and letting them know that the performance of the practice (and therefore them) is being actively measured often has a surprisingly positive effect on staff demeanour towards work.

Review

Of course there is no point implementing change if it isn’t working and so regular reviews are required. Repeated, regular benchmarking allows a practice manager to not only measure the success of changes made, but also identify new key areas of improvement to ensure that every facet of their veterinary business is operating at capacity.

In an increasingly competitive environment, managers have to be business savvy and able to fully harness and respond to all available information and feedback. With benchmarking providing the tools to see if they measure up, veterinary practices can identify their failures and successes. Remove, change or substitute in the areas causing failure and repeat the successes; it really could be that simple.

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So – how confident are you?

As the government reshuffles the deck of ministers to “kick start” the economy and create a team that’s focused on “delivery” in the wider UK economy, how confident are you that these changes will help you and your practice? And how do your experiences compare with the wider veterinary world?

With this in mind, the opinions of those involved in practice management are being sought in the first UK survey designed to explore confidence levels in veterinary practices, during what can be best described as “challenging times”.

“Sponsored by vetpol.co.uk, the survey is quick and easy to complete” says Caroline Johnson. She went on to say, “We are inviting Practice Managers, Owners and others involved in management roles to give up a few minutes of their time to answer a few multiple choice questions, designed to evaluate business confidence. You will be asked how you feel about the recession, your confidence in practice performance and your confidence in making the best of the situation you’re in with the resources you have. The results will be made widely available and should make for some interesting reading!”

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Ten Veterinary Management Lessons Learned Travelling the World

From an article published in the Dave Nicol Blog

Fed up paying out huge fees to travel to management conferences and learning nothing? I’ll save you the trouble. In the last month, I’ve travelled to three continents, attending and presenting at both WSAVA/BSAVA in the UK and CVC East Coast in Washington DC.

Three continents, two conferences and one crazy veterinary world — here’s what I learned.

  • Net Promoter Score rocks — you can read the book for more detail but it boils down to this: how many of your clients are actively recommending you and are advocates for your practice? Getting client feedback, and better still, having this immortalised online in the form of reviews is going to be a huge advantage.
  • Coach your staff like a sports team was Shawn McVey’s advice. If you train hard, have talent and play by the rulebook you generally get to play for a good team, earn more money, have a nicer car, etc. If you do something the coach doesn’t like, coach blows the whistle, pulls you aside and tells you what to do differently. If you consistently fail to do what coach asks then you get dropped, have to play in a smaller team with less pay, smaller house/car, etc. This is how it works in just about every field of business. So why do we struggle with it in veterinary medicine? You are the coach, do you have a playbook and are you blowing your whistle?
  • Be different and be good if you want to succeed. This was the message from an inspirational Marwan Tarazi. Marwan is a small animal practitioner from England who has posted some stellar performance figures from his start-up practice. His targets were to generate annual revenue of £150,000, £250,000 and £350,000 for years one, two and three. He’s smashing these targets out of the park and in his third year is on course to deliver £750,000 — from a one-vet practice! What’s his edge? Marwan would have you believe it was laparoscopic surgery, but we at The Hamster Wheel know different. While everyone was amazed by the success of the clinic, the shrewd members in the audience knew that Marwan would have posted these figures whatever he did. His secret isn’t technology; it’s commitment, passion and chutzpah. Good on you, Marwan.
  • Stop trying to fix people who are psychologically broken. It’s not your job and you are not a shrink. This means you are wasting your time. Instead learn better ways of hiring people who help you achieve, not hold you back.
  • Write a blog. Google will love you and only 4% of clinics do this, so you’ll stand out a mile from the crowd. Post a blog every week if possible and you will out-rank your peers on any search engine listing you like. Think new client gold rush
  • Sign up for a twitter account and get into some meaningful conversations with clients and potential clients.
  • Email is most definitely not dead. Use it to save money, time and get better engagement from your clients. Sack your marketing person if they say otherwise.
  • Even though we are in the economic doldrums, there are a lot of clinics that are growing fast and are very busy. They are doing something dramatically different. In fact, they are doing a lot of things dramatically different. If you’re suffering and haven’t changed anything then you need to act because you’re running out of time.
  • We recruit people really, really badly. We should be getting more help from qualified professionals. Great people power great businesses. It is worth the time and investment to hire well.
  • Getting out there, meeting new people and catching up with old friends is great for the soul, fights isolation and exposes you to different ways of thinking. Make it a priority to attend a conference you have never been to before and throw yourself in hook, line and sinker.

You can click here to visit Dave Nicols website

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6 heated situations: Say this, not that

Extracts from an article by Portia Stewart in the DVM360.com online magazine

Is conflict leaving you hot under the collar when you need to be cool as a cucumber? Put those feelings on ice to extinguish the flames.

How can you calm the volcano in your stomach when there’s a lava of hot words burning its way up your throat? When conflict happens at your veterinary practice, you may struggle to find the right words to cool the angry flow before you erupt. But before you blow your stack, refocus on your target, says Debbie Allaben Gair, CVPM, a Firstline Editorial Advisory Board member and a management recruiter and coach with Bridging the Gap in Sparta, Mich. “It goes back to your goal,” Gair says. “What’s the primary reason your practice is in business?” Most will say that their goal is to take good care of pets and people.

When you make pets and clients your first priority, you hone in on how to offer the services they need, Gair says. This makes it easier to shift your attention from your communication woes to getting things done so you can help pets.

Julie Mullins, a veterinary assistant and staff training coordinator at Seaside Animal Care in Calabash, N.C., agrees. “It’s positioning yourself in the mindset that they’re not out to get you,” she says. “Don’t allow bad feelings to escalate because you’re upset.”

Let’s take a look at a few of the most common scenarios that make your temper spike and examine the right–and wrong–thing to say during these situations.

Case 1: Hot diggity discount

Mrs. Spendalot strolls in on her Prada-shod feet waving her Kate Spade clutch and complains your veterinary services are way too spendy–and she wants freebies or discounts for Ginger the Wonderdog.

Heat it up: “Who are you kidding? You can easily afford it.”

Cool it down: “I’m sorry, Mrs. Spendalot, we don’t offer discounts. To give you a discount we’d have to cut corners on patient care, which no one wants.”

“A client who hears the second answer says, ‘OK, I’m asking for something that cuts care, and I don’t want that,'” says Paul Camilo, CVPM, practice administrator at All Pets Dental in Weston, Fla., and managing partner of Veterinary Consultation Services. “So the discount all of the sudden isn’t that important.”

Sometimes you may find clients are more aggressive with their requests. In these cases, Mullins tries to keep her response positive and explain what she can do for them. “If they’re combative, I try to point out the things we offer that are free or discounted,” Mullins says. For example, if any companies offer a free parasite prevention product with a qualifying purchase, she’ll explain those offers as a way to save money. She’ll also mention senior wellness programs and other practice offers that apply. You can also explain the payment options your practice offers.

Finally, our experts agree that it’s critical to be confident when you speak to clients about cost. Projecting an air of confidence demonstrates your competence. “We can’t be ashamed of what we charge,” Mullins says. “Don’t be apologetic. What you’re doing is worth what you’re charging.”

Case 2: The 4:59 “emergency”

It’s one minute before you’re all set to walk out the door for a fun Friday night, but just before you shut off the phones, Mrs. Jones calls because her baby, Fraidy Cat, has not been herself for the last three weeks. Suddenly, it’s imperative that Fraidy sees the doctor immediately.

Heat it up: “Great job waiting three weeks so this can turn into a so-called emergency. Can’t you wait it out a few more days?”

Cool it down: “The doctor will be glad to take a look at Fraidy Cat, or if you’d prefer, you can take her to our chosen emergency facility.”

Remember, clients don’t have medical training–you do. So asking them to determine how life-threatening, or even just uncomfortable, Fraidy Cat’s illness is isn’t fair to the client or the patient. “I just heard a story recently about a staff member who offered the client the choice to come in that day or tomorrow,” Gair says. “The client chose tomorrow, and the pet died overnight.”

Again, the best approach, Gair says, is to focus on your target: to help pets and potentially save their lives. This includes answering the phone at the end of the day without judging your clients.

“Take the attitude that we’re so grateful that they were able to get to us and we were able to take good care of their pets,” Gair says. “Clients keep us in business. And what kind of client wants to feel you’re annoyed by them or judgmental that they waited three weeks?”

To avoid situations where Fraidy–and furry friends like her–ruin every Friday, Gair suggests you consider these tips to improve your closing process:

  • Turn off the phones five minutes after you close. This way if someone thinks they’re calling just in time, they can get through to you.
  • Assign closers each night. Your manager may assign a veterinarian, technician, receptionist, and assistant to stay later if an end-of-day call comes through. “As long as you understand that on Mondays and Fridays your family may eat dinner without you, but on Tuesdays, Wednesdays, and Thursdays they can count on you leaving at a certain time unless an emergency comes up,
    then maybe we can be more at peace with encouraging those last-minute callers to come in,” Gair says.

Case 3: Emergency exit only

The sign says “Employees Only,” but oblivious clients stroll through your treatment area like they’re touring an exhibit at the local zoo–and you’re on display. How do you get them to stop monkeying around and take your directions seriously?

Heat it up: “Can’t you read? You’re not supposed to be here.”

Cool it down: “Mrs. Jones, I know you’re concerned about Spot. Right now she’s under anesthesia and the doctor is performing an extraction. I’ll let you know as soon as we’re finished and Spot begins to wake up. In the meantime, what questions can I answer for you about Spot’s procedure?”

“You have to redirect them to where they’re supposed to be,” Camilo says. “We can have four anesthetic patients down in the middle of oral surgery or whatever and a client will walk back. And you just politely have someone walk them to where they’re supposed to be and let them know that you’ll take care of their issue.”

It’s also important to remember these clients are motivated by their love for their pets. They may be anxious or fearful–especially if they’ve been waiting a while–or just excited to see their pet that’s been boarded all day.

You know clients will walk into the treatment area, so be ready for them. “When this happens, we have a technician who’ll break off from the procedure and walk clients back up front, explain what’s going on, and hold their hands,” Camilo says. “The best approach is to designate a staff member to watch for clients. You have their beloved pet’s life in your hands, and they’re as concerned as can be.”

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Microchip Pet Door at the London Vet Show

Demand is high for the new SureFlap Microchip Pet Door — specially designed for small dogs as well as larger cats — with hundreds of advance orders placed before it was launched. The company has found that pet owners are particularly receptive to purchasing SureFlap products from their vet as it helps to reduce stress by restricting access to intruders, so they are keen to demonstrate the new Pet Door to vets on stand J40 at London Vet Show.

Reliability is a key feature of SureFlap products. The new door has been built with a curved polycarbonate door and strong hinges to withstand the attentions of the most persistent would-be intruder. Two independently sprung locks prevent the door twisting even when an intruder pushes hard against one corner, which is a common tactic, and double magnets hold the door securely in place.

SureFlap’s industry-leading microchip reader, located within the tunnel, has also been improved for the larger pet door.

Dogs create new challenges for a fixed microchip reader so the range has been further increased to accommodate the wide variety of nose-to-chip distances found in dogs of different breeds. It will also detect pets as they approach the door from any direction. Over-specification ensures that the pet door operates reliably where pets have older or migrated microchips.

The pet door also incorporates new features that customers have said would be useful such as the curfew mode, which allows pet owners to specify the times at which the door is locked or open; ideal for keeping a pet indoors overnight. The settings are controlled like an alarm clock and shown on an integral display screen at the top of the product.

For non-microchipped pets, the pet door also comes with a specially designed, lightweight RFID collar tag. Although the company advocates microchipping, this new functionality was added to give the product a wider appeal. It also means that visiting pets can also be given temporary access very easily.

SureFlap’s use of patented OnTuneTM technology enables the new pet door to be incredibly energy efficient. It runs on 4 C Cell batteries, which last for up to 12 months with typical use, eliminating the requirement to run a mains connection to the door, or to frequently change the batteries.

Customers don’t need to worry about what type or brand of microchip their pet has. The SureFlap Microchip Pet Door is compatible with all international formats of identification microchip; including all 15 digit (FDXB), 10 digit (FDXA & Trovan Unique) and 9 digit (AVID-encrypted) microchips. It also works well with the recently introduced mini microchips.

You are invited to visit the SureFlap stand J40 at the London Vet Show to see the new product in action.

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